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Glickman Urological & Kidney Institute Glickman Urological & Kidney Institute Graphic design and photography were provided by Cleveland Clinic’s Center for Medical Art and Photography. © The Cleveland Clinic Foundation 2017 9500 Euclid Avenue, Cleveland, OH 44195 clevelandclinic.org 2016 Outcomes 17-OUT-426 108374_CCFBCH_17OUT426_acg.indd 1-3 8/31/17 3:02 PM Measuring Outcomes Promotes Quality Improvement Clinical Trials Cleveland Clinic is running more than 2200 clinical trials at any given time for conditions including breast and liver cancer, coronary artery disease, heart failure, epilepsy, Parkinson disease, chronic obstructive pulmonary disease, asthma, high blood pressure, diabetes, depression, and eating disorders. Cancer Clinical Trials is a mobile app that provides information on the more than 200 active clinical trials available to cancer patients at Cleveland Clinic. clevelandclinic.org/cancertrialapp Healthcare Executive Education Cleveland Clinic has programs to share its expertise in operating a successful major medical center. The Executive Visitors’ Program is an intensive, 3-day behind-the-scenes view of the Cleveland Clinic organization for the busy executive. The Samson Global Leadership Academy is a 2-week immersion in challenges of leadership, management, and innovation taught by Cleveland Clinic leaders, administrators, and clinicians. Curriculum includes coaching and a personalized 3-year leadership development plan. clevelandclinic.org/executiveeducation Consult QD Physician Blog A website from Cleveland Clinic for physicians and healthcare professionals. Discover the latest research insights, innovations, treatment trends, and more for all specialties. consultqd.clevelandclinic.org Social Media Cleveland Clinic uses social media to help caregivers everywhere provide better patient care. Millions of people currently like, friend, or link to Cleveland Clinic social media — including leaders in medicine. Facebook for Medical Professionals facebook.com/CMEclevelandclinic Follow us on Twitter @cleclinicMD Connect with us on LinkedIn clevelandclinic.org/MDlinkedin Glickman Urological & Kidney Institute 107 108374_CCFBCH_17OUT426_acg.indd 4-6 8/31/17 3:02 PM Measuring and understanding outcomes of medical treatments promotes quality improvement. Cleveland Clinic has created a series of Outcomes books similar to this one for its clinical institutes. Designed for a physician audience, the Outcomes books contain a summary of many of our surgical and medical treatments, with a focus on outcomes data and a review of new technologies and innovations. The Outcomes books are not a comprehensive analysis of all treatments provided at Cleveland Clinic, and omission of a particular treatment does not necessarily mean we do not offer that treatment. When there are no recognized clinical outcome measures for a specific treatment, we may report process measures associated with improved outcomes. When process measures are unavailable, we may report volume measures; a relationship has been demonstrated between volume and improved outcomes for many treatments, particularly those involving surgical and procedural techniques. In addition to these institute-based books of clinical outcomes, Cleveland Clinic supports transparent public reporting of healthcare quality data. The following reports are available to the public: • Joint Commission Performance Measurement Initiative (qualitycheck.org) • Centers for Medicare and Medicaid Services (CMS) Hospital Compare (medicare.gov/hospitalcompare), and Physician Compare (medicare.gov/PhysicianCompare) • Cleveland Clinic Quality Performance Report (clevelandclinic.org/QPR) Our commitment to transparent reporting of accurate, timely information about patient care reflects Cleveland Clinic’s culture of continuous improvement and may help referring physicians make informed decisions. We hope you find these data valuable, and we invite your feedback. Please send your comments and questions via email to: [email protected]. To view all of our Outcomes books, please visit clevelandclinic.org/outcomes. 108374_CCFBCH_17OUT426_acg.indd 1 8/31/17 3:14 PM Dear Colleague: Welcome to this 2016 Cleveland Clinic Outcomes book. Every year, we publish Outcomes books for 14 clinical institutes with multiple specialty services. These publications are unique in healthcare. Each one provides an overview of medical or surgical trends, innovations, and clinical data for a particular specialty over the past year. We are pleased to make this information available. Cleveland Clinic uses data to manage outcomes across the full continuum of care. Our unique organizational structure contributes to our success. Patient services at Cleveland Clinic are delivered through institutes, and each institute is based on a single disease or organ system. Institutes combine medical and surgical services, along with research and education, under unified leadership. Institutes define quality benchmarks for their specialty services and report on longitudinal progress. All Cleveland Clinic Outcomes books are available in print and online. Additional data are available through our online Quality Performance Reports (clevelandclinic.org/QPR). The site offers process measure, outcome measure, and patient experience data in advance of national and state public reporting sites. Our practice of releasing annual Outcomes books has become increasingly relevant as healthcare transforms from a volume-based to a value-based system. We appreciate your interest and hope you find this information useful and informative. Sincerely, Delos M. Cosgrove, MD CEO and President 2 Outcomes 2016 108374_CCFBCH_17OUT426_acg.indd 2 8/31/17 3:14 PM what’s inside Chairman’s Letter 04 Institute Overview 05 Quality and Outcomes Measures In-Hospital Mortality 07 Length of Stay 08 Nephrology Chronic Kidney Disease 09 Hypertension 16 ICU Nephrology 17 Transplantation 19 Urology Bladder/Voiding Dysfunction 21 Kidney 22 Male Fertility 43 Prostate 45 Urethra/Reconstruction 76 Institute Quality Improvement Initiatives 79 Surgical Quality Improvement 86 Institute Patient Experience 88 Cleveland Clinic — Implementing Value-Based Care 90 Innovations 98 Contact Information 102 About Cleveland Clinic 104 Resources 106 Glickman Urological & Kidney Institute 3 108374_CCFBCH_17OUT426_acg.indd 3 8/31/17 3:14 PM ChairmanChairman’s Letter Letter Dear Colleagues, I appreciate your interest in Glickman Urological & Kidney Institute and taking the time to glance through our 2016 outcomes report. Each year we collect and analyze vital data, not just to satisfy our curiosity, but to ensure that we are indeed improving the quality of care we provide and quality of life for our patients. We remain devoted to excellence and innovation in all aspects of our work -- clinical care, research, and education. We believe our consistently high rankings by U.S. News & World Report (No. 1 or No. 2 in the nation since 2012) reflect this dedication and hard work. Among our accomplishments in 2016: • Developed a nomogram to predict the likelihood of kidney stone passage and help guide follow-up and intervention • Established an oxidation-reduction potential assay using a novel galvanostatic technology as an effective method for measuring oxidative stress in semen and distinguishing normal men from those with male factor infertility • Developed a technique to use a buccal mucosal graft in a salvage robotic laparoscopic pyeloplasty for managing recurrent ureteropelvic junction obstruction • Performed laparoscopic vaginoplasty using a bowel segment in a young woman born without a vagina • Developed new, reliable prostate cancer diagnostic tools • Conducted studies demonstrating that salvage radiotherapy at low PSA after prostatectomy improves outcomes • Published a seminal laboratory guide for reproductive professionals • Constructed a new, state-of-the-art Cleveland Clinic East dialysis facility • Welcomed nearly 1,000 guests at our 14th annual 2016 Minority Men’s Health Fair I welcome your feedback, questions, and ideas for collaboration. Please contact me via email at [email protected], and reference the Glickman Urological & Kidney Institute in your message. Sincerely, Eric A. Klein, MD Chairman, Glickman Urological & Kidney Institute Professor, Cleveland Clinic Lerner College of Medicine 4 Outcomes 2016 108374_CCFBCH_Text_4_Rev1.pdf 1 9/19/17 12:18 PM Institute Overview The Glickman Urological & Kidney Institute’s activities subspecialty training in one or more of the following encompass a unique combination of high-volume and areas: bladder, prostate, kidney, and testicular cancer; challenging clinical cases, extensive basic and translational bladder control; chronic urinary tract infections and scientific efforts, and innovative laboratory research within obstructions; dialysis; hypertension; kidney disease; an environment that nurtures the future leaders of its kidney transplantation; male fertility; pediatric urology specialties. U.S. News & World Report’s “Best Hospitals” and nephrology; prostate disease; sexual dysfunction/ survey has ranked the institute’s urology program as one of impotence; and genitourinary reconstruction. the top 2 programs in the United States every year since These subspecializations enable institute physicians to 2000. In 2016, the survey ranked the institute’s urology gain valuable experience using the latest techniques, and nephrology programs No. 2 in the nation. which fosters development of innovative procedures The institute’s 90 physicians and scientists offer expertise
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